ABSTRACT
Background: During the coronavirus pandemic there was a rapid adoption of telehealth services in psychiatry, which now accounts for 40% of all visits. There is a dearth of information about the relative efficacy of virtual and in-person psychiatric evaluations. Methods: We examined the rate of medication changes during virtual and in-person visits as a proxy for the equivalence of clinical decision-making. Results: A total of 280 visits among 173 patients were evaluated. The majority of these visits were telehealth (224, 80%). There were 96 medication changes among the telehealth visits (42.8%) and 21 among the in-person visits (37.5%) (z = -1.4, p = 0.16). Conclusion: Clinicians were equally as likely to order a medication change if they saw their patient virtually or in person. This suggests that remote assessments yielded similar conclusions to in-person assessments.
ABSTRACT
Background: Burnout in healthcare providers (HCPs) can also impact their families, patients, and the healthcare system as a whole. The Coronavirus Disease (COVID-19) pandemic has had an extraordinary impact on the health care system and on HCPs. The current study examined its association with potential burnout. Methods: An internet survey was mailed to HCPs in the United States (US) and Turkey who agreed to participate. Participants completed demographic and work- related information and the shortened version of the Pines’ Burnout Scale. Chi-Square was utilized for most analyses. Results: Rates of burnout were related to age, with the youngest workers (<35 years) having the highest rate (67.2%) and the older workers (>55 years) having the lowest rate (41.2%;χ2 =15.3, P< 0.001). Women reported higher rates of burnout (67.6%) than men (51.6%, OR=1.96, 95% CI 1.47-2.62, p< 0.001). Frontline workers (in emergency rooms or intensive care units) (70.4% vs. 58.7%, χ2: 5.6, p=0.017) and those involved in COVID-19 care (66.7% vs. 55.5%;OR: 1.6, %95 CI 1.1 to 2.1, p=0.002) reported significantly higher burnout rates than others. Burnout rates were significantly lower when workers believed their employer was taking proper precautions to protect employees from COVID-19 (48.0% vs. 74.5%, OR: 3.1, %95 CI 2.3 to 4.2, p< 0.001). HCPs in Turkey were twice as likely to experience burnout than HCPs from the US (OR=1.95, 95% CI 1.29-2.95). [ FROM AUTHOR]
ABSTRACT
Coronavirus Diseases-2019 (COVID-19) has caused a large global outbreak and has been declared as a pandemic by the World Health Organization (WHO). It has been proposed that COVID-19-related hyperinflammation and dysregulated immune response might play a critical role in developing a cytokine storm which usually progresses to a life-threatening acute lung injury or acute respiratory distress syndrome in infected individuals. Lidocaine, a local analgesic and anti-arrhythmic, is known for its anti-inflammatory actions and has been used to reduce cough and improve respiratory symptoms in severe asthmatic patients. It has a demonstrated safety profile. It is proposed that nebulized lidocaine might be beneficial in reducing cytokines, protecting patients' lungs and improving outcomes in COVID-19 patients when administered via inhalation as an adjunctive treatment for severe respiratory symptoms in patients fighting the novel Coronavirus. Additional investigation is warranted.